Objectives: To compare efficacy of oxybutynin and tolterodine in managing Detrusor Overactivity (DO) in Pakistani patients with different upper motor neuron lesions. Methods: A randomized controlled trial was carried out at Armed Forces... more
Objectives: To compare efficacy of oxybutynin and tolterodine in managing Detrusor Overactivity (DO) in Pakistani patients with different upper motor neuron lesions. Methods: A randomized controlled trial was carried out at Armed Forces Institute of Rehabilitation Medicine, Rawalpindi from January to August 2015 including individuals with a diagnosis of DO as a result of upper motor neuron lesions. Maximal detrusor pressure (MDP) and maximal cystometric capacity (MCC) were measured at baseline and at four months post-treatment. Group-A was treated with tolterodine and group-B with oxybutynin. Results: A total of 60 individuals (mean age: 43.9 ± 15 years) were included. Majority (83.3%) were male and had spinal cord injury as the commonest etiology (56.7%). Group-A had a mean pre-treatment MCC of 188.3 ± 48.2 ml, and a mean post-treatment MCC of 281.5 ± 49.1 ml (p< 0.001). The mean pre-treatment MDP was 83.6 ± 9.5 cm of H2O, and the mean post-treatment value was 40.9 ± 10.2 cm of ...
Objective: To compare the results of the standard urotherapy alone and associated with pelvic floor muscle training alone, and in combination with oxybutynin in treatment of nonmonosymptomatic nocturnal enuresis. Methods: A total of 38... more
Objective: To compare the results of the standard urotherapy alone and associated with pelvic floor muscle training alone, and in combination with oxybutynin in treatment of nonmonosymptomatic nocturnal enuresis. Methods: A total of 38 children aged 5 to 10 years were randomized into three groups: Group I (n=12) that was submitted to standard urotherapy; Group II (n=15), standard urotherapy associated with pelvic floor muscle training; and Group III (n=11), standard urotherapy associated with pelvic floor muscle training and oxybutynin; the treatment lasted 12 weeks. The assessment tools used were playful bladder diary, and a 48-hour bladder diary, before and after treatment. After 2 years, patients were assessed by telephone using a standardized questionnaire. Results: The data of children from the three groups were homogeneous at baseline. After 12-week treatment, all children showed improved symptoms and signs of nonmonosymptomatic nocturnal enuresis, but the differences were not significant among the groups. After 2 years, the three groups showed maintenance of treatment results, but no differences among them. Conclusion: All treatment modalities were effective regarding improved enuresis and lower urinary tract symptoms, but the sample was not large enough to show differences among groups.
